Healthcare Provider Details
I. General information
NPI: 1205134582
Provider Name (Legal Business Name): PINNACLE HEALTH FACILITIES XXXII LP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/10/2011
Last Update Date: 08/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
620 E WOOD ST
CLEARWATER KS
67026-9757
US
IV. Provider business mailing address
5420 W PLANO PKWY
PLANO TX
75093-4823
US
V. Phone/Fax
- Phone: 620-584-2271
- Fax: 620-584-2277
- Phone: 972-931-3800
- Fax: 972-931-3801
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | KS |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | KS |
VIII. Authorized Official
Name: MR.
THOMAS
D
SCOTT
Title or Position: MANAGER
Credential:
Phone: 972-931-3800